Donato Sandro, Caputo Simone, Brombal Luca, Golosio Bruno, Longo Renata, Tromba Giuliana, Agostino Raffaele G, Greco Gianluigi, Arhatari Benedicta, Hall Chris, Maksimenko Anton, Hausermann Daniel, Lockie Darren, Fox Jane, Kumar Beena, Lewis Sarah, Brennan Patrick C, Quiney Harry M, Taba Seyedamir T, Gureyev Timur E
Department of, Mathematics and Computer Science, University of Calabria, Rende, Cosenza, Italy.
Department of Physics and STAR-Lab, University of Calabria, Rende, Cosenza, Italy.
Med Phys. 2025 Jul;52(7):e17950. doi: 10.1002/mp.17950.
Phase-contrast breast CT imaging holds promise for improved diagnostic accuracy, but an optimal reconstruction algorithm must balance objective image quality metrics with subjective radiologist preferences.
This study systematically compares three reconstruction algorithms-filtered back projection (FBP), unified tomographic reconstruction (UTR), and customized simultaneous algebraic reconstruction technique (cSART)-to identify the most suitable approach for phase-contrast breast CT imaging.
Fresh mastectomy samples were scanned at the Australian synchrotron using monochromatic 32 keV X-rays, a mean glandular dose of 2 mGy, flat-panel detectors with 0.1 mm pixels, and 6-m distance between the rotation stage and the detector. Paganin's phase retrieval method was used in conjunction with all three CT reconstruction algorithms. Objective metrics, including spatial resolution, contrast, signal-to-noise, and contrast-to-noise, were evaluated alongside subjective assessments by seven experienced radiologists. Ratings included perceptible contrast, sharpness, noise, calcification visibility, and overall quality.
cSART excelled in objective metrics, outperforming UTR and FBP. However, subjective evaluations favored FBP due to its higher image contrast, revealing a discrepancy between objective and subjective assessments.
The findings highlight the contrast-focused nature of radiologists' subjective assessments and the potential of cSART for delivering superior objective image quality. These insights inform the development of hybrid evaluation tools and guide clinical translation for future live patient imaging studies.
相位对比乳腺CT成像有望提高诊断准确性，但最佳重建算法必须在客观图像质量指标与放射科医生的主观偏好之间取得平衡。
本研究系统比较了三种重建算法——滤波反投影（FBP）、统一断层重建（UTR）和定制同步代数重建技术（cSART），以确定最适合相位对比乳腺CT成像的方法。
在澳大利亚同步加速器上使用单色32 keV X射线、平均腺体剂量2 mGy、像素为0.1 mm的平板探测器以及旋转台与探测器之间6米的距离对新鲜乳房切除样本进行扫描。帕加宁相位检索方法与所有三种CT重建算法结合使用。除了由七位经验丰富的放射科医生进行主观评估外，还评估了包括空间分辨率、对比度、信噪比和对比噪声比在内的客观指标。评分包括可感知对比度、清晰度、噪声、钙化可见性和整体质量。
cSART在客观指标方面表现出色，优于UTR和FBP。然而，主观评估更倾向于FBP，因为其图像对比度更高，这揭示了客观评估与主观评估之间的差异。
研究结果突出了放射科医生主观评估以对比度为重点的性质以及cSART在提供卓越客观图像质量方面的潜力。这些见解为混合评估工具的开发提供了信息，并为未来活体患者成像研究的临床转化提供了指导。
